| NPI | 1811101389 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN BALDWIN Od Owner 916-961-0395 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 12369T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 11460T) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2020-08-22 |